| NPI | 1366835423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE VANIS Office Manager 541-683-0644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: OR MD19682) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2023-02-16 |